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Frame of Thinking Dengue shock Syndrome.pptx
1.
Ad vitam: dubia
ad bonam Ad functionam: dubia ad bonam Ad sanationam: dubia ad bonam Fluid therapy, supportive therapy, Inotropic Drugs (for DSS) Anamnesis - physical examination - laboratory tests (Haematology) – Serology Dengue Apoptosis Aedes aegypti mosquitoes DENV Viral Factors Host Factors Mononuklear cell: Replication of the virus in langerhans cells Enviromental factor Spread via circulation (primary viremia) Infecting macrophages of multiple organs Endotelial Cell Tissue macrophage Bone marrow (replication in stromal cells) Liver cell damage (hepatomegaly) Apoptosis/necrosis/dis turbed liver function Apoptosis Releases toxic products into circulation Coagulation activation Supresi hematopoesis Elevated platelet consumption Trombositopenia Fibrinolytic system activation Coagulation disorder Increase in inflammatory mediators (TNF-Alfa, IL) Cytokine and other mediator imbalances Endothelial cell dysfunction Bleeding Fever, malaise, anorexia Plasma leakage Shock RISK FACTOR PROBLEM DIAGNOSTIC THERAPY PROGNOSIS Liver: replication in hepatocytes and kupffer cells
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